Microorganisms And The Skin

Front 1

Skin's roles

Back 1

control body temperature, maintain fluid balance, and protect the individual from external pathogens

Front 2

When the skin fails as protection

Back 2

colonizers as pathogens
Opportuistic invaders
Frank
Skin conditions as an indication of systemic (measels)

Front 3

What is the most common site of infection in the skin

Back 3

Mucosal membrane

Front 4

Abscess

Back 4

localized collection of pus and associated inflammation

Includes: carbuncles, papules, furuncles, etc.

Front 5

Vesicle

Back 5

a fluid-filled blister (thin-walled sac)

Front 6

Rash

Back 6

an area of irritated skin

Front 7

Erythema

Back 7

reddening of the skin due to capillary congestion

Front 8

Cellulitis

Back 8

acute inflammation of the connective tissue of the dermis

Front 9

What do you take note of when a patient comes in with a rash?

Back 9

History
lesion appearance/evolution
rash appearance/evolution
subsequent culture/histopathology
diagnostic testing

Front 10

VZV

Back 10

Varicella-zoster virus
a large, enveloped, DNA herpies virus

Front 11

Provirus

Back 11

unexpressed viral genes in the genome of host cels

Front 12

Lytic phase

Back 12

making viruses and shedding them

Front 13

latent phase

Back 13

lysogenic phase

Front 14

Chickenpox

Back 14

Latent overall cycle

acute cycle, self-contained

Front 15

List five Chickenpox complication

Back 15

2nd bacterial infections

Encephalitis

Pneumonitis- virus replicate in lungs--- can die 10% of adults with it die.

Reye's-rare but fatal disease when you give child with virus infection- aspirin

Perinatal varicella- mom gets chickenpox

Front 16

Chickenpox's mode of transmission

Back 16

Respiratory---> epithelial cells
Spreads through the blood system and presents itself on skin

Front 17

Shingles

Back 17

2nd round of latent chickenpox...

After host becomes immune suppresed, come down with shingles

Front 18

Who gets shingles?

Back 18

Old people... typically get it once and that's it.

Front 19

What is the purpose of being around chickenpox?

Back 19

Being around chickenpox after you got it keeps your immunity up.

Front 20

VZV's life cycle

Back 20

Life cycle: lytis and latent phases

Makes cells fuse: Multinucleated cells form

Front 21

VZV treatment

Back 21

Acyclovire:

virus kinase (P) at a higher efficiency than human kinases. ACV not activated by us unless we have a virus in the cell that activates the drug.

Front 22

Tinea

Back 22

dermatotide infections

Front 23

onychomycosis

Back 23

nail fungi infection

a specific kind we saw in case 2:
tinea unguium

Front 24

Dermatophytes

Back 24

break down keratin

can live in hair, skin, nails

can be envir bugs , human/human (anthropophilic) contact, or zoophilic

Front 25

Tinea capitis

Back 25

scalp

Front 26

tinea cruris

Back 26

jock itch

Front 27

Tinea unguium

Back 27

nail fungal

Front 28

Dermatophytes modes of transmission

Back 28

direct (cats- ringworms)

Indirect (fomites like hairbrushes and towels)

Front 29

Dermatophyte treatment

Back 29

polyenes

Azoles

More toxic potential because fungi have more similar infrastructure because they are eukaryotic too.

Dangerous when you need to use systemically. Harsh drugs.

Front 30

Early generations of cepholosporin:

Back 30

Injected: ceftriaxone IM

oral: cephalexin

Ab given to treat infections (cellulitis)

Front 31

S. Aureus
Gram test?
Cat and coag test?
Respiration?
Infection looks like?

Back 31

Gram + coccus

catalase and coagulase positive

Facultative anaerobe

Various types of infections (wall themself off and make absesses)

Front 32

Epidemiology

Back 32

part of the indigenous microflora

can be endogenous or exogenous

CA-MRSA has sig morbidity and mortality.

Front 33

Treatment of S. Aureous

Back 33

Penicillin- Peni resistan
vancomycin- vrsa
methicillin- mrsa

Front 34

Drug resistance in S. Aureus

Back 34

Major cause of nosocomial infections

MDR: oxacillin, methicillin, vancomiosin

Front 35

Nosocomial

Back 35

acquired in hospital

Front 36

community acquired

Back 36

get it in the community

Front 37

Furuncles and carbuncles

Back 37

localized skin abscesses, boils

Front 38

Impetigo

Back 38

Superficial infection of the skin usually seen in children:

Front 39

Wound infection

Back 39

frequently post-surgical

Front 40

Foreign Body Infection

Back 40

usually associated with medical devices.

Front 41

Osteomyelitis

Back 41

infection of bone

Front 42

Necrotizing pneumonia

Back 42

frequently secondary to influenza infection

Front 43

Toxic shock syndrome

Back 43

mediated by superantigens (TSST) ; organism may be recovered from the GU tract; antibodies to TSST-1 are found in 90% of adults but are typically absent in individuals who develop staphylococcal toxic shock syndrome

Front 44

Virulence Factors to S. Aureus

Back 44

Adhesins- fibronectin-binding proteins- important in adherence to endothelial surfaces and foreign objects such as intravascular devices
Hyaluronidase - degrades acellular matrix of connective tissue; important in spread of organism through tissue
Hemolysins – membrane damaging toxins – five have been recognized, including Panton-Valentine leukocidin - creates lytic pores in the membrane of leukocytes, releasing cytokines that contribute to skin/soft tissue infections as well as pneumonia
Epidermolytic toxins- superantigens, cause exfoliation of skin
Enterotoxins - produced by half of Staphylococcus aureus strains - heat stable proteins – act as superantigens, including Toxic shock syndrome toxin (TSST)
Protein A - binds the Fc portion of IgG coating the bacteria so it may not be seen as “foreign” by phagocytes; may have a role in immune evasion

Front 45

Where is S. Aureus part of the natural flora?

Back 45

Anterior nares, skin, and female GU tract

Front 46

Is MRSA only nosocomial?

Back 46

No, there is MRSA that is CA with significat morbidity and mortality.